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Custom Fabricated Wheelchair Back Cushion

Massachusetts rates for HCPCS E2617

Custom fabricated wheelchair back cushion, any size, including any type mounting hardware

Rates data updated July 2026.

Facilitymedian $676 · 10th–90th $407$6760%50%10th$676Professionalmedian $676 · 10th–90th $676$7940%50%90th$676$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$691.83
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$407.38
Typical High
$758.58
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$794.33
Health New England
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$588.84
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$794.33